The treatment of inoperable sarcoma by bacterial toxins (the mixed toxins of the Streptococcus erysipelas and the Bacillus prodigiosus).

WB Coley - Proceedings of the Royal Society of Medicine, 1910 - journals.sagepub.com
WB Coley
Proceedings of the Royal Society of Medicine, 1910journals.sagepub.com
First, I wish to emphasize the point that the method rests upon a solidfoundation of accepted
and indisputable clinical facts-namely, that in a considerable number of cases of inoperable
cancer of all varieties, and especially sarcoma, such tumours have been known entirely to
disappear under attacks of accidental erysipelas, and patients have remained well for many
years thereafter. For those who refuse to accept clinical results unless confirmed by
laboratory experiments, these latter tests have now been supplied, since during the lasttwo …
First, I wish to emphasize the point that the method rests upon a solidfoundation of accepted and indisputable clinical facts-namely, that in a considerable number of cases of inoperable cancer of all varieties, and especially sarcoma, such tumours have been known entirely to disappear under attacks of accidental erysipelas, and patients have remained well for many years thereafter. For those who refuse to accept clinical results unless confirmed by laboratory experiments, these latter tests have now been supplied, since during the lasttwo years Dr. Martha Tracy and Dr. SP Beebe, of the Huntington Cancer Research Fund, have shown that large multiple sarcomas in dogs rapidly disappear under both local and systemic injections with the mixed toxins of erysipelas and Bacillus prodigiosus. My attention was first called to the curative effect of accidental erysipelas in inoperable sarcoma by a certain case observed in 1891. In my studies of sarcoma at that time I made a careful analysis of all the cases of sarcoma (90 in number) operated upon at the New York Hospital during the preceding fifteen years. Among thesecases was a small round-celled sarcoma of the neck, four timesrecurrent. At the fifth operation, in 1884, Dr. Bull found thetumour to involve the deep structures so extensively that it was impossible to remove it, and he gave up the atteinpt. The case was regarded as absolutely hopeless, when, shortly after the operation, the man developed a very severe attack of accidental erysipelas in the face and neck, followed two weeks later by a second attack. Within a few days after the beginning of the first attack the tumour began to soften and decrease rapidly in size. The history stated that when the patient left the hospital his tumours had entirely disappeared. There was no after-record of thecase, but I made an effort to trace the patient, and finally found him alive and well, with no evidence of any local or general recurrence in the spring of 1891, seven years later. He was examined both by Dr. Bull and myself.(Fig. 1.)
At this time I had not read of Fehleisen's experiments in Germany in inoculating patients with inoperable malignant tumours with the streptococcus of erysipelas; but I was so strongly impressed with the case I have related that I determined to try inoculations in the first suitable case. In a very short time-May 2, 1891-I made my first
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